Orthopedic surgical instrument



Dec. 30, 1969 a. M. MORRISON ORTHOPEDIC SURGICAL INSTRUMENT Filed May22, 1967 uuummu INVENTOR.

GORDON M- MORRISON Wifdr/ AT TORNEY United States Patent 3,486,505ORTHOPEDIC SURGICAL INSTRUMENT Gordon M. Morrison, 77 N. San MateoDrive, San ,Mateo, Calif. 94401 Filed May 22, 1967, Ser. No. 640,272Int. Cl. A61b 17/00, 17/18; A61m 29/00 US. Cl. 128--303 4 ClaimsABSTRACT OF THE DISCLOSURE An instrument to distract (separate) twoclosely adjacent objects (as bodies of the vertebrae) and at the sametime inserting an object (as a bone graft) between the distractedobjects. The instrument acts as a protective guide and channel to theinserted object ,(as in inserting a bone graft between adjacentvertebral bodies) and at the same time acting as a protective retractorto adjacent soft tissues. The depth of insertion is controlled.

BACKGROUND OF THE INVENTION At the present time, it is common practicefor orthopedic surgeons to apply a sling around a patients neck and thendraw the sling so as to distract or separate adjacent vertebral bodies;and while the patient is under such traction, a bone graft is actuallyhammered into a final position between the distracted vertebral bodies,and the implanted bone graft will unite the adjacent vertebral bodies.

SUMMARY An object of this invention is to provide an orthopedic surgicalinstrument that may be readily used to distract two closely adjacentvertebral bodies and at the same time inserting a bone grafttherebetween, with the depth of insertion being controlled, andobviating the need of hammering the bone graft in place. Moreover, theinstrument is so designed as to act as a protective guide and channel tothe inserted bone graft and serving as a protective retractor toadjacent soft tissue of an incision that is made in the patient toexpose the vertebral bodies to be repaired.

BRIEF DESCRIPTION OF THE DRAWING For a better understanding of theinvention, reference should be had to the accompanying drawing, formingpart of this specification, in which:

FIG. 1 is a side elevational view of my orthopedic surgical instrumentwith the tips thereof disposed in proximate relationship with respect toeach other;

FIG. 2 is another elevational view disclosing the instrument being usedto insert a bone graft between two distracted adjacent vertebral bodies;

FIG. 3 is a further elevational view of the instrument with part of alateral guide broken away and a sliding block being shown in section;

FIG. 4 is a top plan view of the orthopedic surgical instrument; and

FIG. 5 is a transverse sectional view taken along the vertical plane 5-5of FIG. 3.

While I have shown only the preferred embodiment of my invention, itshould be understood that various changes, or modifications, may be madewithin the scope of the appended claims without departing from thespirit of the invention.

DESCRIPTION OF THE PREFERRED EMBODIMENT Referring now to the drawing indetail, it will be noted that a fragmentary portion of a patients spinalcolumn has been shown in FIG. 2. It is well known that such a PatentedDec. 30, 1969 spinal column is composed of an articulated series ofvertebrae connected by ligaments and separated by elastic intervertebralfibrocartilages. In this view of the drawing, two adjacent vertebralbodies A that are normally disposed in closely adjacent relation havebeen distracted (separated) by my orthopedic surgical instrument B, witha bone graft C being inserted between these distracted vertebral bodiesso that the latter may be fused or united together.

The orthopedic surgical instrument B is provided with a supporting frame10 having a pair of arms 11 mounted for movement toward and away fromone another, the arms extending generally lengthwise with respect toeach other, each arm being provided with a tip 12 at its forward end,the tips being movable into proximate (close) relationship relative toone another (see FIG. 1) so that they may be inserted between closelyadjacent vertebral bodies A. The arms 11 define a channel 13 into whichthe bone graft C may be placed, with the tips 12 in contact with oneanother, as in FIG. 1.

A sliding block 14 is disposed between the arms 11 and is anchored tothe forward end of a threaded rod 15 in a position to engage with andadvance the bone graft C between and forwardly of the tips 12. As thisblock is advanced from the position disclosed in FIG. 1 to the positionshown in FIG. 2, the arms 11 and their tips 12 will be spread apart bythe advancing block, resulting in distracting the adjacent vertebralbodies A to provide sufiicient space therebetween for reception of thebone graft C, and at the same time advancing the bone graft into a finalposition between the distracted vertebral bodies A. The arms 11 and tips12 are located to engage with and guide the -bone graft C forwardly toits final position.

Moreover, the supporting frame is U-shaped and is made from resilientmaterial, with the arms 11 and their tips 12 being biased toward oneanother so as to yieldingly maintain contact with the bone graft C asthe latter is advanced between and projects beyond the tips.

A pair of spaced lateral guides 16 are provided on opposite sides of thesupporting frame, and have been shown as being welded to the lowermostarm. These guides are located to hold the bone graft C between the arms11 as the bone graft is advanced, the later-a1 guides and arms acting asa protective retractor to adjacent soft tissues of an incision made inthe patient to reach and expose the vertebral bodies A. These lateralguides define forward ends that are located to engage with one of thevertebral bodies A to limit or control insertion of the tips 12 betweenthe vertebral bodies (see FIG. 2), thereby preventing damage to thespinal cord.

It will be seen that a handle 17 is provided on the supporting frame 10that may be grasped by a surgeon to hold the instrument in place.

The rod 15 previously mentioned is threaded through the handle 17 andhas its forward section projecting into the channel 13 between the arms11, the rod being advanced toward the tips 12 when the rod is turned inone direction and retracted relative to the tips when the rod is turnedin the opposite direction. The sliding block 14 may be anchored to theforward end of the rod 15 by set-screws 18 that extend into an annulargroove 19 formed in the rod (see FIGS. 3 and 4), with the rod being freeto rotate relative to the block 14. Cross-bar 20 may be used to rotatethe rod 15 and forward movement of the rod is limited by adjustable nuts21 on the rod, thereby limiting insertion of the bone graft between thedistracted vertebral bodies.

It will be apparent from FIGS. 4 and 5 that the lateral guides 16 arewelded to the lower arm 11 (or otherwise secured thereto), and that theupper arm 11 will pass between these guides as the tips 12 are movedinto proximate relationship (see FIG. 1). Also, the lateral-guides actas a gauge to the width of the implanted objected (as a bone graft).

Although I have described my instrument in detail with respect toorthopedic surgery, it may be used in other applications Where it isdesired to distract (separate) closely adjacent objects and move aninsertable object into a final position between the distracted objects.

I claim:

1. In an orthopedic surgical instrument:

(a) a supporting frame having a pair of arms mounted for movement towardand away from one another, the arms extending generally lengthwise withrespect to each other, each arm being provided with a tip at its forwardend, the tips being movable into proximate relationship relative to oneanother so that they may be inserted between closely adjacent vertebralbodies;

(b) the arms defining a channel therebetween into which a bone graft maybe inserted;

(0) operating means actuatable to spread the tips apart so as todistract said adjacent vertebral bodies to provide suificient spacetherebetween for reception of the bone graft, and at the same timeadvancing the bone graft into a final position between the distractedvertebral bodies, the arms and tips being located to engage with andguide the bone graft forwardly to its final position;

(d) a pair of spaced lateral guides provided on opposite sides of thesupporting frame and located to hold the bone graft between the arms asthe bone graft is advanced, the lateral guides and arms acting as aprotective retractor to adjacent soft tissues of an incision made in thepatient to reach said vertebral bodies;

(e) the lateral guides defining forward ends that are located to engagewith one of said vertebral bodies to limit insertion of the tips betweenthe vertebral bodies;

(f) and the lateral guides being secured to one of the arms and disposedso that the other arm will pass between these guides as the tips aremoved into proximate relationship.

2. The orthopedic surgical instrument, as set forth in claim 1;

(g) and in which the supporting frame is made from resilient material,with the arms and their tips being biased toward one another so as toyieldingly maintain contact with the bone graft as the latter isadvanced between and projects beyond the tips.

3. The othopcdic surgical instrument, as set forth in claim 1;

(g) and in which adjustable means are provided to limit the depth ofinsertion of the bone graft between said distracted vertebral bodies.

4. The orthopedic surgical instrument, as set forth in claim 1;

(g) and in which a handle is provided on the supporting frame that maybe grasped by a surgeon to hold the instrument in place;

(h) the operating means comprising:

(1) a rod threaded through the handle and having a forwarded sectionprojecting into the space between-the arms, the rod being advancedtoward the tips when the rod is turned in one direction and retractedrelative to the tips when the rod is turned in the opposite direction;

(2) and a sliding block disposed between the arms and being anchored tothe forward end of the rod in a position to engage with and advance thebone graft between and forwardly of the tips with sufficient force toinsert the bone graft into its final position between the distractedvertebral bodies.

References Cited UNITED STATES PATENTS 242,443 6/1881 Foote 128-3451,331,737 2/1920 Ylisto l28345 2,435,531 2/1948 Carmichael l28-3453,136,040 6/1964 Bauer et al. l28354 X RICHARD C. PINKHAM, PrimaryExaminer RICHARD J. APLEY, Assistant Examiner US. Cl. X.R.

